A new preoperative prognostic scoring system to predict prognosis in patients with locally advanced pancreatic body cancer who undergo distal pancreatectomy with en bloc celiac axis resection: A retrospective cohort study-猫眼课题宝

DOI：

10.1016/j.surg.2013.10.024

发表时间：

2014-03-01

期刊：

SURGERY

影响因子：

3.8

通讯作者：

中科院分区：

医学2区

文献类型：

作者：

Miura, Takumi;Hirano, Satoshi;Kondo, Satoshi

背景远端胰腺切除术联合腹腔干整块切除术（DP-CAR）对局部晚期胰体癌提供了良好的局部控制，但仍会发生早期复发。在这项研究中，我们的目的是建立一个新的评分系统，以预测预后，使用术前因素的局部晚期胰体癌患者谁接受DP-CAR。使用从50名接受DP-CAR的连续患者中回顾性收集的各种数据分析预后因素。根据这些术前因素，建立了一个预测预后的评分系统。多变量分析确定术中失血>= 940 mL;风险比[HR 25.179; P = .0003），术前血小板计数（= 0.4 mg/dL; HR，7.064; P = .0018）和术前碳水化合物抗原19-9（CAI 9 -9）水平（>= 300 U/mL; HR，8.197; P = .0053）作为独立的不良预后因素。对于3个术前因素，术前血小板计数= 0.4 mg/dL和术前CA 19 -9水平>= 300 U/mL各分配1分。总评分定义为术前预后评分（PPS）。26例PPSO患者的估计疾病特异性1年和5年生存率分别为95.7%和49.1%，15例PPS 1患者的估计疾病特异性1年和5年生存率分别为86.7%和不可用。PPSO和PPS 1的中位生存时间分别为50.6和22.3个月。而9例PPS 2/3患者的1年和5年生存率分别为33.3%和0%，中位生存期仅为7.7个月。使用术前血小板计数、CRP和CA 19 -9的新预后评分系统可用于术前预测预后，并有助于为可切除的局部晚期胰体癌临界病例选择适当的治疗

Background. Distal pancreatectomy with en bloc celiac axis resection (DP-CAR) provides good local control for locally advanced pancreatic body cancer, but early recurrence still occurs. In this study, we aimed to establish a new scoring system to predict prognosis using preoperative factors in patients with locally advanced pancreatic body cancer who undergo DP-CAR.Methods. Prognostic factors were analyzed using various data collected retrospectively from 50 consecutive patients' who underwent DP-CAR. Using these preoperative factors, a scoring system to predict prognosis was established.Results. Multivariate analysis identified intraoperative blood loss >= 940 mL; hazard ratio [HR 25.179; P = .0003), preoperative platelet counts (= 0.4 mg/dL; HR, 7.064; P = .0018), and preoperative carbohydrate antigen 19-9 (CAI9-9) levels (>= 300 U/mL; HR, 8.197; P = .0053) as independent adverse prognostic factors. For the 3 preoperative factors, preoperative platelet counts = 0.4 mg/dL, and preoperative CA19-9 levels >= 300 U/mL were allocated 1 point each. The total score was defined as the Preoperative Prognostic Score (PPS). The estimated disease-specific 1- and 5-year survival rates for the 26 patients with PPSO were 95.7%, and 49.1%, respectively, and for the 15 patients with PPS1, they were 86.7% and not available, respectively. The median survival times for PPSO and PPS1 were 50.6 and 22.3 months, respectively. In contrast, in the 9 patients with PPS2/3, 1- and 5-year survival rates were 33.3% and 0%, respectively, and median survival time was only 7.7 months.Conclusion. A new prognostic scoring system using the preoperative platelet count, CRP, and CA19-9 enables preoperative prediction of prognosis and facilitates selection of appropriate treatment for borderline resectable cases of locally advanced pancreatic body cancer

A new preoperative prognostic scoring system to predict prognosis in patients with locally advanced pancreatic body cancer who undergo distal pancreatectomy with en bloc celiac axis resection: A retrospective cohort study

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